Funding Mental Health Services Can Pay off for the Taxpayers, as well as the Beneficiaries

Dane County took a big step forward when it received a grant from the MacArthur Foundation to support expansion of its restorative justice activities. We have been less successful in mobilizing support for expansion of the mental health services that would help keep people out of jail.

But, investments in those services can pay off. Bexar County in Texas is the site of a national model that has inspired county governments throughout the country to improve their treatment of people with mental illness and save taxpayer dollars

At the heart of the model are the Crisis Care and Restoration Centers. Together, they offer 24/7 screening for mental illness, an inpatient psychiatric unit, outpatient psychiatric services, and a variety of substance abuse treatment options. A police officer can drop off an individual with a mental health crisis and be back on the street within 15 minutes. Referrals also come from mobile crisis teams, the courts, sobriety unit, mental health professionals, and families.

The two centers serve about 2,200 people per month who otherwise would have gone to jail or emergency rooms or back to the streets. Before the centers were available, law enforcement officers spent an average of 12 to 14 hours in emergency rooms waiting for psychiatric evaluations. They now wait about 15 minutes. The county saves more than $10 million per year on averted jail costs and emergency room costs.

How did they do it? It took sustained commitment by a wide variety of dedicated people in the criminal justice, county government, and health care communities. The effort began more than a decade ago.

Identifying and securing funding was key. Among the sources are Medicaid, Medicare, and the University Health System. The county secured state funds that allow it to earn Medicaid Administrative Claims, which can cover from 25 to 30 percent of the cost of diverting an individual from jail.

County administrators encouraged state hospitals and other institutional practitioners to seek funds from private insurance, Medicaid managed care payers, and the Veterans Administration. They received grants from the federal Substance Abuse and Mental Health Administration and foundations.